14D0962111 CLIA NUMBER - WENDELL A WHEELER MD

Laboratory Demographics

  • CLIA Code: 14D0962111
  • Facility Name: WENDELL A WHEELER MD
  • Facility Address: 1052 W 111ST STREET
    CHICAGO, IL
    ZIP 60643
  • Facility Phone: 773 779-7337
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WENDALL A. WHEELER
  • NPI Number: 1902808611
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D0962111
LAB Type Physician Office
Facility Name WENDELL A WHEELER MD
Street 1052 W 111ST STREET
City CHICAGO
State IL
ZIP 60643
Phone 773 779-7337
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/23/2025
Certificate Expiration Date 6/22/2027
Facility Type Physician Office
Lab Director WENDALL A. WHEELER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025